New Nutraceutical Combination Reduces Blood Pressure and Improves Exercise Capacity in Hypertensive

Capacity in Hypertensive Patients Via a Nitric Oxide-Dependent Mechanism

J Am Heart Assoc. 2020 Mar 3;9(5):e014923 New Nutraceutical Combination Reduces Blood Pressure and Improves Exercise Capacity in Hypertensive Patients Via a Nitric Oxide-Dependent Mechanism. Carrizzo A1, Moltedo O2, Damato A1, Martinello K1, Di Pietro P3, Oliveti M3, Acernese F2, Giugliano G4, Izzo R4, Sommella E2, Migliarino S5, Piazza O3, Izzo C3, Virtuoso N6, Strianese A3, Trimarco V7, Campiglia P2, Fucile S1,8, Puca A3,9, Trimarco B4, Vecchione C1,3. Author information 1 IRCCS Neuromed Pozzilli Italy. 2 Department of Pharmacy University of Salerno Fisciano Italy. 3 Department of Medicine and Surgery University of Salerno Baronissi Italy. 4 Department of Advanced Biomedical Sciences University Federico II of Naples Italy. 5 Department of Clinical and Molecular Medicine School of Medicine and Psychology Sapienza University of Rome Italy. 6 Department of Cardiovascular Medicine A.O.U. Federico II Naples Italy. 7 Department of Advanced Biomedical Sciences Federico II University Hospital Naples Italy. 8 Department of Physiology and Pharmacology Sapienza University of Rome Italy. 9 Cardiovascular Research Unit IRCCS MultiMedica Milan Italy. Abstract Background High blood pressure (BP) has long been recognized as a major health threat and, particularly, a major risk factor for stroke, cardiovascular disease, and end-organ damage. However, the identification of a novel, alternative, integrative approach for the control of BP and cardiovascular protection is still needed. Methods and Results Sixty-nine uncontrolled hypertension patients, aged 40 to 68 years, on antihypertensive medication were enrolled in 2 double-blind studies. Forty-five were randomized to placebo or a new nutraceutical combination named AkP05, and BP, endothelial function, and circulating nitric oxide were assessed before and at the end of 4 weeks of treatment. Twenty-four patients were randomized to diuretic or AkP05 for 4 weeks and underwent a cardiopulmonary exercise test to evaluate the effects of AkP05 on functional capacity of the cardiovascular, pulmonary, and muscular systems. Vascular and molecular studies were undertaken on mice to characterize the action of the single compounds contained in the AkP05 nutraceutical combination. AkP05 supplementation reduced BP, improved endothelial function, and increased nitric oxide release; cardiopulmonary exercise test revealed that AkP05 increased maximum O2 uptake, stress tolerance, and maximal power output. In mice, AkP05 reduced BP and improved endothelial function, evoking increased nitric oxide release through the PKCα/Akt/endothelial nitric oxide synthase pathway and reducing reactive oxygen species production via NADPH-oxidase inhibition. These effects were mediated by synergism of the single compounds of AkP05. CONCLUSION This is the first study reporting positive effects of a nutraceutical combination on the vasculature and exercise tolerance in treated hypertensive patients. Our findings suggest that AkP05 may be used as an adjunct for the improvement of cardiovascular protection and to better control BP in uncontrolled hypertension. KEYWORDS: exercise capacity; nitric oxide; vascular biology PMID: 32078787 DOI: 10.1161/JAHA.119.014923 FULL-TEXT